Comparative Pharmacology
Head-to-head clinical analysis: CANAGLIFLOZIN versus INVOKAMET XR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CANAGLIFLOZIN versus INVOKAMET XR.
CANAGLIFLOZIN vs INVOKAMET XR
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Sodium-glucose cotransporter 2 (SGLT2) inhibitor; reduces renal glucose reabsorption, increasing urinary glucose excretion.
Combination of canagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, which reduces renal glucose reabsorption and lowers blood glucose, and metformin, an activator of AMP-activated protein kinase (AMPK) that decreases hepatic glucose production and improves insulin sensitivity.
100 mg orally once daily; may increase to 300 mg once daily for additional glycemic control.
Maximum daily dose: canagliflozin 300 mg/metformin ER 2000 mg orally once daily with the morning meal. Initial dose: canagliflozin 50 mg/metformin ER 500 mg orally twice daily or canagliflozin 150 mg/metformin ER 1000 mg orally once daily; for patients not currently on metformin, start with canagliflozin 50 mg/metformin ER 500 mg orally twice daily; for patients on metformin, switch to INVOKAMET XR based on current metformin dose.
None Documented
None Documented
Clinical Note
moderateCanagliflozin + Gatifloxacin
"Canagliflozin may increase the hypoglycemic activities of Gatifloxacin."
Clinical Note
moderateCanagliflozin + Rosoxacin
"Canagliflozin may increase the hypoglycemic activities of Rosoxacin."
Clinical Note
moderateCanagliflozin + Levofloxacin
"Canagliflozin may increase the hypoglycemic activities of Levofloxacin."
Clinical Note
moderateCanagliflozin + Trovafloxacin
"Canagliflozin may increase the hypoglycemic activities of Trovafloxacin."
Terminal elimination half-life: 10.6–13.1 hours (single dose); steady-state: ~12.9 hours. Clinically, supports once-daily dosing with sustained SGLT2 inhibition over 24 hours.
Canagliflozin: mean terminal elimination half-life is 13.1 hours (range 11-16 hours) for the 300 mg dose, consistent with once-daily dosing. Metformin: terminal elimination half-life is approximately 6.2 hours (range 4-9 hours) in patients with normal renal function; prolonged in renal impairment.
Renal: 33% (primarily tubular secretion, ~1% unchanged in urine; remainder as glucuronide metabolites); Fecal: 52% (as parent drug and metabolites); Biliary: minor (enterohepatic circulation suspected but not quantified).
Canagliflozin is primarily excreted as unchanged drug in urine (approximately 33%) and feces (approximately 41%), with about 7% as metabolites in urine and 34% as metabolites in feces. Metformin is excreted unchanged in urine (90-100% of absorbed dose) via tubular secretion and glomerular filtration.
Category C
Category C
SGLT2 Inhibitor
SGLT2 Inhibitor / Biguanide Combination